LEWISTON — To prevent schoolwide outbreaks of the seasonal flu or H1N1, the state is imposing strict rules, including sending students and staff with flu-like symptoms home.

The symptoms include a fever of 100 degrees or higher, coughing, or a runny nose, sore throat, nausea, vomiting and headache. Students must stay out of school until their temperature has been normal for 24 hours without Tylenol or other medication.

Like Auburn, the Lewiston School Committee recently voted to follow the Maine Center for Disease Control’s recommendation to offer all school-age children seasonal flu shots, followed by H1N1 vaccines. Officials are urging parents to ensure their children have the shots, warning that school-age children are the most vulnerable to H1N1.

Parents of Lewiston students should look for permission slips being sent home Tuesday.

The forms are to be filled out and returned as soon as possible, so the School Department knows how much vaccine is needed, Lewiston High School nurse Cathy Liquori said. No students will be given the shots unless a parent has filled out and returned the form.

Liquori recommends parents take advantage of the vaccines.

“It not only protects their child from becoming ill from the flu, it will prevent other kids from getting sick and attendance will be better.”

Children 9 years and older only need one seasonal flu shot. Children 8 and younger who have not had a flu shot before will need two. In those cases, they’ll need one flu shot followed by a booster. Those children will have to get their booster at their primary care doctor, Liquori said.

Regular flu shots will be given at Martel and Longley elementary schools only on Tuesday, Sept. 22, Liquori said.

At Lewiston Middle School and Lewiston High School, the two largest schools, shots will be given for the weeks of Sept. 21 and 28.

At all other schools, shots will be given Monday through Friday from Sept. 21-25, Liquori said.

In addition to getting flu shots, “we’re stressing children in families need to cough in their elbow, staying away from people who are sick, not sharing water bottles, and practice and properly wash their hands,” the nurse said.

The right way to wash hands is to completely lather hands with soap and scrub “while singing the ‘Happy Birthday To You’ song, the whole thing,” to ensure hands have been washed long enough, Liquori said. “Most adults don’t do it that long.”

Posters are going up in schools reminding students to take steps to guard against getting the flu and H1N1 this year. There’ll also be hand sanitizers in every classroom, Liquori said.